| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.15 | $10,429.99 | $30,836.50 | |
Aetna
| Professional | $5.66 | $11.15 | $101.20 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
Wellpoint
| Professional | $40.21 | $40.21 | $40.21 |